MEMBERSHIP APPLICATION
APPLICANT INFORMATION
MEMBERSHIP TYPE (SELECT ONE)
Mail this completed form and a check payable to “LSSSCA” to:
Lone Star State School Counselor Association
P.O. Box 485
Needville, TX 77461
NAME:
HOME ADDRESS:
CITY / STATE / ZIP:
PHONE:
EMAIL ADDRESS:
SCHOOL:
DISTRICT:
CURRENT JOB / POSITION:
WORK ADDRESS:
CITY / STATE / ZIP:
PHONE:
EDUCATIONAL SERVICE CENTER REGION #:
SUBMIT FORM & PAYMENT
Professional Membership ($30). School counseling professionals who
hold a master’s degree or higher in school counseling or the substantial
equivalent and are employed as school counselors, supervisors of
school counselors, or professors of counseling in a graduate program
that prepares school counselors are eligible for Professional
membership.
Retired Members ($20). Professional members in retirement are
eligible for Retired membership.
Student Membership ($20). Students enrolled in a master’s level
program that prepares school counselors are eligible for Student
membership.
Affiliate Membership ($30). Individuals interested in school
counseling, who are not eligible for any other type of membership, are
eligible for Affiliate membership.
